Impact of performance status on non-small-cell lung cancer patients with a PD-L1 tumour proportion score ≥50line pembrolizumab.

Alex Friedlaender, Giulio Metro, Diego Signorelli, Alessio Gili, Panagiota Economopoulou, Fausto Roila, Giuseppe Banna, Alessandro De Toma, Andrea Camerini, Athina Christopoulou, Giuseppe Lo Russo, Marco Banini, Domenico Galetta, Beatriz Jimenez, Ana Collazo-Lorduy, Antonio Calles, Panagiotis Baxevanos, Helena Linardou, Paris Kosmidis, Giannis MountziosMarina C. Garassino, Alfredo Addeo

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: We retrospectively analysed patients with advanced non-small-cell lung cancer (NSCLC) harbouring high PD-L1 expression (textgreater50 and treated with front-line pembrolizumab, comparing outcomes of patients with an Eastern Cooperative Oncology Group (ECOG) performance status (PS) 2 to those with PS 0-1.Methods: Data were collected by 16 participating centres. All patients with NSCLC and high PD-L1, treated with first-line pembrolizumab were included. We collected medical data from patient files, pathology and laboratory reports. Patient characteristics, comorbidities, PS, and tumour characteristics were reported. Overall survival (OS), progression-free survival (PFS) and response rate (RR) were calculated.Results: 302 patients were included, 246 with PS 0-1, 56 with PS 2. RR was 72-1 compared to 45 (odds ratio (OR) 0.31 (95 0.17-0.57), p textless .001). Median PFS was 2.6 months (95 1.9-5.1) among patients with PS2 and 11.3 months (95 8.5-14.4) among those with PS 0-1. Median OS was 7.8 months (95 2.5-10.7) in the PS2 group, not reached in the PS 0-1 group. PS 2 remained predictive of poor outcomes in multivariate analysis.Conclusion: PS 2 is a strong independent predictor of poor response and survival in NSCLC patients with high PD-L1, treated with front-line pembrolizumab. Prospective randomised trials comparing immunotherapy to chemotherapy in this population would be welcome.
Original languageEnglish
JournalActa Oncologica
Issue number9
Publication statusPublished - Sep 1 2020

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